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HomeMy WebLinkAbout622 RHINE LN - Building Permits .. 4251.9 ;e—` COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 1 APPLICATION FOR STRUCTURAL PERMIT For Applicant-to-Fill n•Compietely —Use Ink Only ' RECEIVED BY O•TE RECEIV D BUILDING r — DE I SUE•4 ADDRESS 420 422 424626 Ramie Lw -', _ • D OWNER , ,I\�L � _7/ E�IrE/1�/1/lE1' i A.P. No. 1/-07 -0/ ADDRESS 74, 4 /I eaA BUILDING 6' - /2/ eve pre4 ' —L0 . ADDRESS /s _ /j r/ cY `t/i Ns�-- Y L ^ TEL. ' TRACT �/ / LOT / BLOCK CITY qsf NO. 1 CONSTRUCTION tie A. 1 NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER /�� BRANCH `�/AIAI I �J .� ' OWNER �etee2 ADDRESS ///J is VALUE �//,/s' ARCHITECT TEL. USE d U4//v &AlUU $ /./u• �� OR ENGINEER NO. -. ' FIRE ADDRESS C LL��tt ZONE / TY'E 1 GROUP > 1 450 deZTLE2 . APPROVED ! u DATE EGD-7-6 - CONTRACTOR BY • ADDRESS TEL. J '� C.• E NO.OF USE OF NEW 4 (J'.li•r CITY NO. ` IPLANS BUILDING CONDO STATE 2�� 9 CITY { YARDS APPROVED YARDS APPROVED LIC. NO. ! LIC. NO. MAIN BUILDING ACCESSORY BUILDING LQ SIZE NO.OF BLDGS. (FROM CA.STREET) C. OF LOT I NOW ON LOT FRONT FT. Q USE OF f C& EXISTING BLDG. R SIDE P1 F�al FT, CA F Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. Li] a REAR FT. FT. F• USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET,MAIN& 'C /�, s MAIN BLDGS. ACCESS. BLDGS. VAR DATE ', ¢ am/r- tD�lJQ P CUP.# 71-77 APPROVED ., APPROVED J DATE O 'I 92G G CC OLD FOR SPFCI I REQUIREMENTS S A. I hereby acknowledge that I have read this application and state n C that the above information is correct and agree to comply with m G all laws regulating building construction, and I shall not employ Z any person in violation of the workmen's compensation laws of E E IQ the State of California. _ • C I herebycertifythat I amSO, FT. rq properly licensed as a contractor under the State of California Business and Professions Code, Division 3, .` THE AMOUNT SHOWN UNDER VALUATION IS FOR ra Cnapter 9, and that such licenses are in full force and effect, or I 'y: THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business II VALUATION37/ ac) • e and Professions Code, Division 3,Chapter 9. PERMIT FEE $ N Pa mettee of G de'Llte2 / 2,0 $• PLAN CHECK $ Z¢/� /5 LL Authorized Agent /5e coo OOO TAX $ /a•fY 2 • D1TOTAL PAID $ GZj, o T